Case Report : Anomalous Right Coronary Artery from Pulmonary Artery with Aorto-Pulmonary Window and Ventricular Septal Defect

  • Hariadi Hadibrata, Resident of Indonesian Cardiothoracic and Vascular Surgery Program, Indonesia
  • Budi Rahmat, Staf of Pediatric & Congenital Heart Surgery, National Cardiovascular Center Harapan Kita, Jakarta,, Indonesia
  • Pribadi Busro, Staf of Pediatric & Congenital Heart Surgery, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
  • Dicky Fakri, Staf of Pediatric & Congenital Heart Surgery, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
  • Poppy Roebiono, Pediatric Cardiologist, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
  • Novik Budhiwardana, Pediatric Intensive Care Unit, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
  • Eva Harahap, Pediatric Intensive Care Unit, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia

    • Introduction
    Anomalous Right Coronary Artery from Pulmonary Artery (ARCAPA) is a very rare cardiac anomaly, where the right coronary artery is origin from pulmonary artery. It’s incidence has been estimated as 0,002% of the population. Anatomically there are 4 variation of the origin coronary artery from pulmonary artery : Left coronary artery, ( most frequently ), Right coronary artery, both coronary artery from pulmonary artery ( most lethally) and accessory coronary artery. Frequently, ARCAPA is found occasionally at coronary examination or surgery. We report a child with ARCAPA, AortoPulmonary Window (APW ) and ventricular septal defect,( VSD ) undergoing surgical repair

    Case
    A 3-year old girl weighing 8500 gr, was admitted to the hospital with chief complaint cough, and fever and recurrent dyspnoe . Echocardiography and catheterization demonstrated an ARCAPA with APW and VSD as well as Pulmonary Hypertension. A surgical repair of the AortoPulmonary septal defect and reimplantation of right coronary artery from pulmonary artery to aorta as well as closure of VSD was conducted. Postoperative Ekokardiografi revealed no residual of APW or VSD. Follow-up at4 0 days , there was no complaint, better activity and increase of body weight

    Conclusion
    ARCAPA is a rare congental cardiac diseases. Simptom and severity of the disesase depends on variation of origin of the coronary artery. Patient can grow and develop well after the adequate surgical treatment.